In a desperate dispatch from Puerto Rico on Thursday, where less than 20% of the population has electricity and the death toll continues to rise three weeks after Hurricane Maria, the mayor of San Juan sent an exceedingly clear message about how dire the situation has become.

“Simply put: HELP US. WITHOUT ROBUST and CONSISTENT HELP WE WILL DIE,” Mayor Carmen Yulín Cruz wrote in a statement texted to Rep. Luis Gutiérrez and shared with Splinter. “Stop the genocide that will result from the lack of appropriate action of a president that just does not get it.”

“Your tweets and comments just show desperation and underscore the inadequacy of your government’s response to this humanitarian crisis. It is not that you do not get it, it is that you are incapable of empathy and frankly simply cannot get the job done,” Cruz wrote.

She went on the praise the selfless work of around 300 volunteers helping with the relief effort in the city:

These men and women, most of them union workers, have literally taken care of our bodies and souls. They did not come for a photo op or to throw paper towels and insults at us. They came to help, something you seem to be unable to grasp. These volunteers have seen the horror that you continue to want to dismiss. They embody the true spirit of the American values that you dismiss with every inappropriate and derogatory action and comment.

“While you are amusing yourself throwing paper towels at us, your compatriots and the world are sending love and help our way,” she said. “Condemn us to a slow death of non drinkable water, lack of food, lack of medicine while you keep others eager to help from reaching us since they face the impediment of the Jones Act.”

Congress still hasn’t passed a relief package for Puerto Rico. More insidiously, House Republicans are considering a bill that would include aid in the form of a loan, which the impoverished island would have to pay back, rather than a grant. Faced with life or death conditions in Puerto Rico, Trump, along with Republicans in Congress, have made their choice perfectly clear.